Watchman Procedure

Had 2 ablations, the last one with a bleed in the groin , back in the hospital took me off eliquis and bleeding stopped.Much better, but my Apple watch and Kardia say Iam in Afib every morning. Put on Holter monitor came up a rare form of tachycardia, not sure what that means. Meanwhile eliquis is causing little red dots on my trunk and-arms and my hair has started to fall out and my head itches like a bear. Tried xarelto after my stroke caused severe dizziness, so looking at prodaxa and the watchman. Have numbness in my toes and terrible cramps in my legs and hands.
My question is does the watchman hurt the heart and cause loss of blood flow and circulation?
Also where do the blood clots go, do they dissolve on their own or do the sit behind the watchman device, and why do you still have to take drugs ,I have a problem with aspirin so what then?

The Watchman precludes the formation of clots because it closes off the 'grotto' in which they are most likely to form when the heart is fibrillating or in flutter. PACs and other arrythmias don't cause strokes nearly as likely due to their nature. The Watchman is placed and held there, and eventually it gets covered in tissue, sealing off the grotto. Think of a shallow cave just a few feet deep, but with its face closed off with a wall of bricks. With the wall of bricks in place, blood cannot enter, fail to circulate, get 'stale', and begin to clot.

The Watchman does not hurt the heart. Arrythmias do eventually if left unmanaged, and clots do. If you get a clot in your Left Anterior Descending artery that feeds the heart, you're...ummm....dead...pretty much. Similarly, the process of creating fibrosis around the pulmonary veins to isolate them electrically from the rest of the atrial endothelium does not 'hurt' the heart. I mean, it's not exactly ideal that they're in there causing burns to create scarring, but the alternative is a runaway atrium that continues to balloon in size, that can compromise the mitral valve between it and the ventricle below it. The heart heals, just like your skin does, but with a scar, just like your skin does. Meanwhile, you're back in sinus, and life goes on apace.

The anti-coagulants do not dissolve clots. They retard their formation. They don't prevent clots...they just make the blood less eager to form them. They buy you more time if what is in the left atrial appendage, for example, pools, circulates poorly, and then begins to clot. Instead of maybe 20 seconds for this to take place, the apixaban or rivaroxaban makes the clotting slower, more like a 40 second to minute-long timeframe.

The greatest single risk from an arrythmia like flutter or fibrillation is stroke. The drugs are meant to retard the mechanism that causes stroke...meaning clots dislodging from the appendage and working their way downstream to the heart, the lungs, or the brain. So, even if you have the odd bout of an arrhythmia, say a few seconds a day, or once each week, you still run the risk of that clot (IF...it forms) departing from its place of origin and traveling to the brain or to the heart. The anti-coagulant is an insurance policy with pretty decent success. It would be unethical for your physician to not mention this possibility, and its best current remedy or preventative measure...which in this case are two small pills each day, noon and night.

Getting the Watchman changed my life. No more meds, no more tests and I can eat my spinach. Go for it.

I’m still in the final stages. My TEE after Watchman implant has shown my Watchman has not moved since surgery and the echocardiogram reflects all is well. I won’t have my discussion with My EP about stopping Xarelto for a couple more weeks. After the recent TEE, my EP reduced my Xarelto to 15mg. I’ve been on 20mg for a very long time as strokes appear in my ancestral history. The final outcome for me hopefully will be plavix and baby aspirin. No more bloody arms. I will post more as I progress.

I’m also a fall risk due to having cerebral palsy since birth, very mobile & independent with a walker just since 2012. I’m now 76 & started Eliquis in February. My cardiologist did a cardio ablation for a-fib last week & wants to schedule a Watchman procedure in a couple of months. I’d love to hear of anyone’s experience with having this done - pros & cons you’ve encountered.

My guess (and it is a guess) having a watchman recently installed is that your doctor doesn’t want you to fall (or be in accident etc) and have a brain bleed. Each blood thinner has serious side effects especially if you are on them a long time, there is also research regarding how they can affect cognitive function. My procedure went well and I’m waiting for my EP to take me off Xarelto. I won’t miss the bruises and easy skin tears on my arms.
I wish you all the best and I feel it was the right decision for me. I’m close to your age and have been on blood thinners for 15 years prior.

There are several of us posting on here about recent Watchman implants. Do a search to find them. Sorry I don’t know how to find them or would direct you.
Perhaps one of the moderators can advise you.

Thank you for all the positive input on the Watchman device. I was diagnosed with Afib in 2019, but the occurrences were so rare that I was just put on Eliquis and watched every 6 months. By 2022 the Afib turned into full time and though I still had no side effects they did an ablation. Two years later I never feel Afib occurrences, but they gave me a 30 day heart monitor to see if I was having them without knowing. I got a call yesterday stating that the monitor showed some Afib during the 30 days. I also have osteoporosis so they tell me I have a high fall risk. However, I am in good physical shape and work out regularly so I believe that's not a problem yet. I'm 70. I bruise very easily and have not been taking Eliquis as prescribed as I didn't think I was having incidents of Afib. I'm pretty confused at this point and don't really trust the doctors in my area. Is traveling for a reputable doctor worth it? Has anyone out there done that? Thanks!

For you, and your state of mind at the moment, maybe a recommendation to a top-tier electrophysiologist is not a bad idea. I can recommend Dr. Andrea Natale at the Texas Cardiac Arrhythmia Institute in Austin, although he does have privileges in several western hospitals, including in CA. He and Dr. Pasquale Santangeli at Cleveland Clinic have saved a lot of people from going bonkers over their disordered hearts.

You should be on two 5 mg tablets of apixaban daily to reduce your risk of stroke. Start yesterday. Bruises won't kill you, but a stroke stands a pretty solid chance at you.

Your AF needs to be reduced both in frequency and in its mental burden. The longer you are in AF, the greater the risk of stroke as well as of developing heart failure (really it's just a weakened heart, not a heart that will eventually stop beating because it gets worse). Also, the longer you are in AF, the more the left atrium enlarges, or stretches, and this creates 'stretch marks' inside of it that become scar tissue. This encourages even more atrial fibrillation, and it can cause the valve between it and the left ventricle to prolapse, which ALSO encourages more AF. You can't win at this game due to the disorder's progressive nature. Get on top of this right away!

Thank you. I have been told to have the Watchman. I have been on Eliquis for about 5 years. Last year I developed a GI bleed which led to getting a blood transfusion. I also had a fall which resulted in a cut on my head. Both incidents have resolved but my EP wants me to have the Watchman implant so I can get off blood thinners. I have not had any bleeding since last year. I sought a second opinion at Cleveland Clinic. They agreed that the Watchman would be a good idea. I am very apprehensive so your post gave me something positive to think about. I could wait to see if I have another incident but that means waiting for everything to heal in order to do the procedure. Or I could proceed while I'm in good health. Decisions!